-
Journal of Functional Morphology and... Jan 2024Female athletes subjected to various types of impact loading, especially over a long period of time, may experience changes in their pelvic orientation, which may affect...
Female athletes subjected to various types of impact loading, especially over a long period of time, may experience changes in their pelvic orientation, which may affect their sport performance and increase the likelihood of injury. The aim of the present study was to determine whether female athletes involved in high-impact loading sports (HILS), odd-impact loading sports (OILS), and repetitive non-impact loading sports (NILS) demonstrate changes in pelvis orientation compared to non-athletes (NATH). Pelvic orientation was determined using Euler/Cardan angles, calculated from the coordinates of the right, and left anterior superior iliac spines and pubic symphysis via a novel method. Two-way ANOVA tests showed significant differences between groups for pelvis position in the frontal plane ( < 0.05), with HILS and OILS demonstrating greater pelvic obliquity compared to NILS athletes and NATH. Significant main effects were also obtained for directions within the sagittal plane ( < 0.001). Significant within-group differences were observed in sagittal pelvic position among female athletes engaged in NILS ( < 0.01) and non-athletes (NATH) ( < 0.05), with a greater anterior pelvic tilt compared to posterior. Our findings suggest that pelvis orientation in female athletes across sports is influenced by sport-specific impact loads, potentially affecting performance and injury occurrence.
PubMed: 38249096
DOI: 10.3390/jfmk9010019 -
Arthroplasty Today Feb 2024Instability is a known complication following total hip arthroplasty (THA) and is influenced by spinopelvic alignment. Radiographic markers have been investigated to...
BACKGROUND
Instability is a known complication following total hip arthroplasty (THA) and is influenced by spinopelvic alignment. Radiographic markers have been investigated to optimize the acetabular cup position. This study evaluated if the empty ischial fossa (EIF) sign and the position of the trans-teardrop line were predictive of postoperative instability.
METHODS
All patients who underwent THA from 2011 to 2018 at a single institution were retrospectively reviewed. Pelvic tilt was measured using a trans-teardrop line compared to the superior aspect of the pubic symphysis on standing anteroposterior pelvis radiographs. Postoperative dislocations were identified through chart review and radiographic review. The EIF sign was determined by the presence of uncovered bone below the posterior inferior edge of the acetabular component at the level of the native ischium and posterior wall on standing postoperative anteroposterior radiographs.
RESULTS
One thousand seven hundred fifty patients (952 anterior approach and 798 posterior approach) were included. The EIF sign was present in 458 patients (26.2%) and associated with an increased dislocation rate (3.9% vs 0.9%, < .0001). Patients with spondylosis/instrumented fusion, and positive EIF sign had a dislocation risk of 5.1% vs 1.3% ( = .001). A postoperative outlet pelvis was not significant for increased dislocation risk (odds ratio 2.16, = .058). Patients with combined spondylosis/fusion, posterior approach, outlet pelvis, and EIF sign had a dislocation rate of 14.5%.
CONCLUSIONS
The EIF sign was an independent risk factor for postoperative instability and may represent failure to account for pelvic tilt. Avoidance of the EIF sign during cup positioning may help reduce dislocations following THA.
PubMed: 38235398
DOI: 10.1016/j.artd.2023.101309 -
Cureus Dec 2023Digital templating using pre-operative radiographs enables pre-operative planning for total hip arthroplasty (THA). This allows surgeons to reproduce hip biomechanics...
Digital templating using pre-operative radiographs enables pre-operative planning for total hip arthroplasty (THA). This allows surgeons to reproduce hip biomechanics effectively, reducing the risk of post-operative complications. Pelvic radiographs demonstrating the head, neck, trochanters, and proximal one-third of the femoral shaft allow calculation of key measurements including femoral offset and limb length discrepancy (LLD). Currently, no standardised guideline exists for obtaining pre-operative radiographs for templating in THA. Materials and methods: A single-blinded retrospective cohort study assessing the quality of pre- and post-operative radiographs of 195 patients who underwent elective THA for osteoarthritis over a two-year period was performed. Quality was rated as good, fair or poor, respectively, depending upon whether ≥2, 1 or none of the following were met: Pubic symphysis (PS) and coccyx in a straight line with 1-3 cm between the superior edge of the PS and tip of coccyx, trochanters distinguishable, obturator rings symmetric. Post-operative images were assessed to determine whether the distal end of the implanted prosthesis was visible. Results: The sample consisted of 195 patients. Pre-operatively 115 (59%) radiographs were classified as good, 71 (36.4%) fair and 9 (4.6%) poor. Post-operatively 46 (23.6%) were classified as good, 114 (58.4%) as fair and 30 (15.4%) as poor. In the post-operative radiographs, 25.6% did not include the distal tip of the prosthesis. Conclusion: This study highlights significant scope to improve the quality of pre-operative radiographs, allowing accurate templating to optimise outcomes for THA. A protocol is recommended whereby the pelvic radiograph is centred on the PS at the lesser trochanter level, ensuring adequate exposure of the proximal femur, acetabulum and iliac crests.
PubMed: 38229784
DOI: 10.7759/cureus.50687 -
Experimental and Therapeutic Medicine Jan 2024Lipoma is a common type of benign soft tissue tumor that can occur in the shoulders, neck and back, in addition to other body parts. The Retzius space is a small...
Lipoma is a common type of benign soft tissue tumor that can occur in the shoulders, neck and back, in addition to other body parts. The Retzius space is a small anatomical space between the pubic symphysis and the bladder located extraperitoneally and filled with loose fatty connective tissue. Giant lipomas are rare in the Retzius space. A 61-year-old Chinese male arrived at Beijing Yanhua Hospital (Beijing, China) due to frequent urination, and CT scan images of the lower abdomen observed a large pelvic mass and left inguinal hernia. Preoperative clinical manifestations and auxiliary examination suggested that the tumor originated from the urinary bladder wall. The maximum tumor diameter was ~25 cm and abdominal pressure was increased. Therefore, laparoscopic pelvic tumor resection combined with inguinal hernia repair was attempted. Intraoperatively, the tumor was found to originate from the Retzius space and the postoperative pathological diagnosis was lipoma. The present case report may serve as a reference for minimally invasive treatment of this type of rare disease in future.
PubMed: 38223329
DOI: 10.3892/etm.2023.12290 -
Physical Therapy in Sport : Official... Mar 2024Evaluate the inter-examiner reliability of pain provocation tests for hip adductors (palpation, stretch and resistance) and for pubic symphysis (palpation) in athletes...
Clinical examination tests for adductor- and pubic-related groin pain in athletes with longstanding groin pain: Inter-examiner reliability and prevalence of positive tests.
OBJECTIVES
Evaluate the inter-examiner reliability of pain provocation tests for hip adductors (palpation, stretch and resistance) and for pubic symphysis (palpation) in athletes with longstanding groin pain, and to determine the prevalence of positive tests.
DESIGN
Inter-examiner reliability.
SETTING
Orthopaedic and sports medicine hospital.
PARTICIPANTS
Male athletes with longstanding groin pain.
MAIN OUTCOME MEASURES
Inter-examiner reliability, absolute/positive/negative agreement, and the mean prevalence of positive tests for athletes classified with adductor- and pubic-related groin pain were calculated.
RESULTS
We included 44 male athletes with longstanding groin pain (61 symptomatic sides). The mean age was 29 years (±6) and 70% were soccer players. Inter-examiner reliability was slight to moderate for adductor palpation (Cohen's Kappa statistic(κ)) = 0.02-0.54) and pubic palpation (κ = 0.37-0.45); moderate for the adductor stretch test (κ = 0.50), and fair to substantial for adductor resistance tests (κ = 0.22-0.74). Palpation pain was most prevalent at the adductor longus origin (94%) in athletes classified with adductor-related groin pain.
CONCLUSION
The inter-examiner reliability of palpation tests varied from slight to moderate. The adductor stretch test had a moderate reliability, and adductor resistance tests a fair to substantial reliability. Adductor longus origin is the main site for palpation pain. Adductor palpation tests not related to the adductor longus have limited inter-examiner reliability. The adductor stretch test did not assist in classifying adductor-related groin pain.
Topics: Humans; Male; Adult; Groin; Prevalence; Reproducibility of Results; Pelvic Pain; Athletes; Athletic Injuries
PubMed: 38219694
DOI: 10.1016/j.ptsp.2023.12.008 -
Zhongguo Xiu Fu Chong Jian Wai Ke Za... Dec 2023To review the research progress of pubic symphysis diastasis and provide effective reference for orthopedic surgeons in the diagnosis and treatment of pubic symphysis... (Review)
Review
OBJECTIVE
To review the research progress of pubic symphysis diastasis and provide effective reference for orthopedic surgeons in the diagnosis and treatment of pubic symphysis diastasis.
METHODS
The anatomy, injury mechanism, treatment, and other aspects of pubic symphysis diastasis were summarized and analyzed by reviewing the relevant research literature at domestically and internationally in recent years.
RESULTS
The incidence of pubic symphysis diastasis is high in pelvic fractures, which is caused by the injury of the ligaments and fibrocartilage disc around the pubic symphysis by external force. The treatment plan should be individualized according to the pelvic stability and the needs of patients, aiming to restore the stability and integrity of the pelvis and improve the quality of life of patients after surgery.
CONCLUSION
At present, the research on pubic symphysis diastasis still needs to be improved. In the future, high-quality, multi-center, and large-sample studies are of great significance for the selection of treatment methods and the evaluation of effectiveness for patients with pubic symphysis diastasis.
Topics: Female; Humans; Fractures, Bone; Pelvis; Pubic Symphysis; Pubic Symphysis Diastasis; Quality of Life; Biomedical Research
PubMed: 38130199
DOI: 10.7507/1002-1892.202306093 -
Cureus Nov 2023Pelvic girdle pain (PGP) during pregnancy is a major source of stress for mothers. This review summarizes studies on the effectiveness of functional stability exercises... (Review)
Review
Pelvic girdle pain (PGP) during pregnancy is a major source of stress for mothers. This review summarizes studies on the effectiveness of functional stability exercises (FSEs) in preventing PGP during pregnancy. FSE is a rising area of study in maternal health, focusing on core muscle groups and addressing the biomechanical changes during pregnancy. Although data shows that FSE may relieve PGP and improve the quality of life in pregnant women, the research landscape is defined by limitations and differences in intervention parameters among studies, resulting in contradictory conclusions. As a result, the efficacy of FSE in pregnant women with PGP remains inconclusive. This review can help comprise the existing research on FSE alleviating PGP in pregnancy to provide full knowledge on the topic, analyze long-term effects, and develop practice guidelines. While FSE shows promise, treating the multidimensional nature of PGP in pregnancy requires a comprehensive approach to therapy that incorporates several therapeutic modalities.
PubMed: 38098896
DOI: 10.7759/cureus.48769 -
Revista Do Colegio Brasileiro de... 2023it is estimated that approximately 20 million people undergo inguinal hernia surgery annually in the world, with the Lichtenstein technique being the most performed... (Review)
Review
INTRODUCTION
it is estimated that approximately 20 million people undergo inguinal hernia surgery annually in the world, with the Lichtenstein technique being the most performed surgical procedure. The objective of this study is to analyze the knowledge of the technical principles used in the Lichtenstein technique.
METHOD
Survey-type intersectional study approved by the research ethics committee of São Camilo University Center (CAAE: 70036523.1.0000.0062). During the research period, 11,622 e-mails were sent to members of the main national surgical societies with research on the technical principles of Lichtenstein surgery. The survey was carried out using an electronic form with 10 multiple-choice questions. The form was answered anonymously on the SurveyMonkey and Google Forms platforms.
RESULT
744 responses were received to the electronic form. Based on this number of respondents, our survey has a confidence level of 95% with a margin of error of 3.5%. It was observed that there is no standardization of the technique among the majority of responders (53.4%). Many surgeons still perform digital dissection of the spermatic cord (47%). A small number of interviewees (15.2%) performed sutures with absorbable thread in the region of the internal oblique aponeurosis, while more than half (55.2%) continued to perform sutures with non-absorbable thread. Most surgeons use a small overlap or fix the mesh juxtaposed to the pubic symphysis (51%).
CONCLUSION
Our research identified that a small percentage of respondents adequately know the technical principles of Lichtenstein surgery. The result brings us new insights into the need to review Lichtenstein technique.
Topics: Humans; Male; Dissection; Groin; Hernia, Inguinal; Herniorrhaphy; Recurrence; Surgical Mesh
PubMed: 38088634
DOI: 10.1590/0100-6991e-20233655-en -
Spartan Medical Research Journal 2023Sacral fractures are an important consideration in high-energy traumas associated with injuries to the pelvic ring that confer much of pelvic stability. A midline...
INTRODUCTION
Sacral fractures are an important consideration in high-energy traumas associated with injuries to the pelvic ring that confer much of pelvic stability. A midline longitudinal sacral fracture (MLS) is a relatively rare fracture pattern, with only 23 cases of MLS fractures reported in the literature to date. This systematic review evaluates overall mechanisms of MLS injury, associated injuries, complications, management, and fracture prognosis.
METHODS
A 1952-2021 PubMed literature search yielded 11 publications reporting the outcomes of a total of 23 MLS fracture cases.
RESULTS
Of the 23 MLS patients, 15 (65%) were male and eight (35%) were female, with an average age of 37.25. Ten (43.5%) MLS fractures occurred during motor vehicle collisions and eight (34.7%) because of motorcycle accidents. The most common pelvic ring injuries associated with MLS were pubic symphysis diastasis (n = 12, 57%) and pubic ramus fractures (n = 11, 48%). Patients most frequently suffered intra-pelvic organ dysfunction such as sexual dysfunction or bowel/bladder/urethral injuries. Fractures were treated both operatively or non-operatively and generally showed clinical meaningful resolution at 10 weeks post-injury.
CONCLUSIONS
MLS injuries most often occur in high-energy trauma due to motor vehicle or motorcycle accidents as well as crush injuries, leg splitting, direct perineal/perianal impacts. Pre-trauma sacral abnormalities could be potentially predisposing factors correlated with MLS fractures. Careful review of x-rays and CT scans may help reveal MLS fractures, which can go initially undiagnosed. Operative and nonoperative management strategies includes bedrest, transsacral transiliac screw, decompressive laminotomies, and/or pelvic external fixation. The outcomes reported to date have been generally favorable, with most patients healing at approximately 10 weeks. Keywords: Midline sacral fracture; vertical sacral fracture; sacrum; pelvic ring injury.
PubMed: 38084338
DOI: 10.51894/001c.38909